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Biomedical subjects

C Parker

Publications and source records attributed to C Parker.

At least 145 records · Page 8Linked to original sources
PubMed1990

Children from disrupted and adoptive homes on an inpatient unit.

Among 375 children and adolescents admitted to a psychiatric hospital inpatient unit, the proportion of adopted children was considerably higher than that of a general pediatric population or of census figures, and the majority of nonadoptees were from disrupted homes. Based on a review of case records, adoption and family disruptions appear to increase significantly the length of hospitalization and to shift diagnoses toward behavioral disturbances. Implications for prevention and treatment are considered.

Adolescent↗
PubMed1990

The role of midazolam and flumazenil in urology.

The effects of midazolam (3-10 mg i.m.) and their reversal by flumazenil were studied in transurethral endoscopic procedures performed using topical analgesia. In one randomised study, patients (n = 84) received either no medication or flumazenil (0.5 mg i.v.) on completion of endoscopy. Recovery was assessed subjectively. Within 15 min, 83% of those receiving flumazenil were considered ready for discharge compared with only 24% of the control group (P less than 0.001). In a second randomised, double-blind, placebo-controlled trial of 44 patients, post-operative recovery was assessed using five objective psychomotor tests. Whereas the placebo group took up to 2 h to recover, those receiving flumazenil recovered fully or returned to near control values within 15 min. Sedoanalgesia--a technique combining adequate local anaesthesia with sedation (using midazolam)--has wide application in urology, and the introduction of flumazenil has major implications for the practice of day-case surgery.

Adult↗
PubMed1990

Skin lesions in transplant patients.

A multitude of skin lesions that are seen following organ transplantation have been presented. Many of them, such as opportunistic infections, are related to the immunosuppressive agents used to prevent graft rejection and graft-versus-host disease. Corticosteroids and cyclosporine commonly produce other skin changes as well. A high index of suspicion for unusual infections and skin cancer should lead the dermatologist to initiate the proper diagnostic procedures in these patients.

Drug Eruptions↗
PubMed1990

Mammography in Connecticut: current estimates of capacity and usage.

All 124 registered mammography facilities in Connecticut were surveyed in 1988 to determine the availability, quality, and usage of mammography services. A total of 112 responses (90% return) were analyzed. By the measures considered here, capacity and quality of mammography in Connecticut is very good to excellent. Services are available in Connecticut in a wide array of locales, times, and settings. Since 1985, 95 new dedicated machines have been put into service. We estimate that current capacity may exceed 400,000 annual studies. Utilization is below current capacity; roughly 155,000 examinations were completed in 1988. Continued recognition of the procedure's effectiveness, particularly in screening women for evidence of early disease, can help reduce the burden of breast cancer.

Connecticut↗
PubMed1990

Encouraging screening mammograms. Results of the 1988 Connecticut Breast Cancer Detection Awareness Campaign.

Connecticut's first Breast Cancer Detection Awareness Campaign during April 1988 offered low-cost screening mammograms ($50) to women over age 34 who had not been previously examined. Following a brief mass media campaign, some 2,500 inquiries about the program were received over a seven-day period, resulting in 1,243 examinations of the detection of eight breast cancers. Program participants cited an enhanced awareness that a baseline examination was due, and knowledge about the availability of low-cost services as reasons for obtaining a screening mammogram. Their reasons for not having been previously screened included not having been advised by physicians to have such an examination (28%); high cost (37%); and failure to recognize the importance of periodic screening (21%). By contrast, relatively few women expressed concern about the test procedure (12%), or fear of finding cancer (9%) as reasons for not being screened previously. These findings underscore the benefit of cancer control efforts to reduce access and information barriers to regular use of mammography by women.

Adult↗
PubMed1989

Diversity in the practice of district ethics committees.

A survey of ethics committees in district health authorities was carried out to find out the size and make up of committees and what information and guidance they offered to scientists who apply to do research. A sample (n = 28) of committees in England (n = 190), half from teaching districts and half from non-teaching districts, was contacted by post requesting this information. A high degree of diversity was found, not only in the methods that committees used but also in the ethical criteria each considered to be pertinent for research. It was also shown that published guidelines have made little impact. It is suggested that issuing more guidelines will be of limited use. Rather, the following are needed: information about why guidelines have been widely ignored, better communication between committees, some form of education for committee members, and a formal register of committees compiled.

England↗
PubMed1989

The in-hospital development of cardiogenic shock after myocardial infarction: incidence, predictors of occurrence, outcome and prognostic factors. The MILIS Study Group.

The incidence, outcome and predictors of the in-hospital development of cardiogenic shock and its prognostic significance were analyzed in 845 patients presenting with acute myocardial infarction. Cardiogenic shock developed after hospitalization in 60 patients (7.1%). In half of these patients, cardiogenic shock developed at least 24 h after hospital admission. The in-hospital mortality rate was greater than 15 times higher for patients with cardiogenic shock than for patients without shock (65.0% versus 4.3%, respectively, p less than 0.001). Enzymatic evidence of infarct extension occurred in 23.3% of the patients with shock compared with 7.4% of those without shock (p less than 0.0001). Multivariate analysis indicated that independent predictors for the in-hospital development of cardiogenic shock were age greater than 65 years (p = 0.007), left ventricular ejection fraction on hospital admission less than 35% (p = 0.007), large infarct as estimated from serial enzyme determinations (that is, peak creatine kinase-MB isoenzyme greater than 160 IU/liter (p = 0.008), history of diabetes mellitus (p = 0.011) and previous myocardial infarction (p = 0.012). Patients with three, four or five of these risk factors had a 17.9%, 33.7% or 54.4% probability, respectively, of developing cardiogenic shock after hospital admission. Left ventricular function, as reflected by left ventricular ejection fraction (p = 0.04) and severity of left ventricular wall motion abnormality (p = 0.04), was the most important determinant of in-hospital mortality in the patients with cardiogenic shock.

Age Factors↗
PubMed1988

Characterization of a third form of the human T cell receptor gamma/delta.

A subpopulation of the CD3+ peripheral T lymphocytes express the TCR-gamma/delta complex. Three distinct TCR-gamma forms that differ in size and in the ability to form a disulfide bridge with the TCR-delta subunit have been described. In this study we analyze the structural difference between the non-disulfide-linked 55-kD and 40-kD TCR-gamma chains. The 40-kD TCR-gamma form contains a smaller polypeptide backbone and carries less carbohydrate compared with the 55-kD TCR-gamma form. A cDNA clone corresponding to the 40-kD TCR-gamma subunit lacks one copy of the second exon of the constant region that is present in the other TCR-gamma subunit. This exon copy encodes part of the connector region that is located between the constant domain and the membrane spanning region. We show that the number of potential N-linked glycan attachment sites are the same for the two TCR-gamma forms. Since these attachment sites are located in the connector region we conclude that the connector region influences the amount of N-linked carbohydrates added to the core TCR-gamma polypeptide, probably by affecting the conformation of the protein. In contrast to the TCR-beta constant region usage, the TCR-gamma constant regions are unequally expressed. Virtually exclusive usage of disulfide-linked complexes were found in some individuals, while both the disulfide-linked and the 40-kD, non-disulfide-linked TCR-gamma forms were detected in other subjects. The ability to distinguish these TCR-gamma/delta forms now makes it possible to study the mechanisms that govern their selection and to determine if they correspond to functionally distinct isotypes.

Amino Acid Sequence↗